EPA Consensus Project Paper: The Vertical Dimension of Occlusion. How to Determine and How to Alter? A Systematic Review.

PURPOSE: The aim of this systematic review was to explore the dental literature to identify high quality clinical studies that introduced methods of determining the vertical dimension of occlusion (VDO), and additionally to find studies which assessed alterations in the VDO. MATERIALS AND METHODS: An electronic search of the literature was conducted through PubMed , Embase, and Cochrane Library databases referring to the determination and alteration of the VDO by 12/2021. RESULTS: A total of 215 records were obtained from the initial search. After the first two screenings, 33 studies were selected for inclusion. Correlations in the morphometric group ranged between r=0.18-0.87, p⟨0.05-0.001, correlations in the cephalometric group ranged between r=0.28-0.92, p⟨0.05-0.001, and correlations in the mechanometric group ranged between r=0.21- 0.75, p⟨0.05-0.01. Regarding the alteration of VDO, in all studies the increase ranged between 1.8-8 mm and the patients adapted . CONCLUSIONS: No clear guidelines can be established yet, in relation to the determination and alteration of the VDO. There is no apparent benefit in using more invasive and complex methods compared to the use of the facial anatomical landmarks. Patient adaptation seems to be successful when the range of VDO increase was 1.8-6.0 mm.

Factors Affecting Decision-Making For Congenitally Missing Permanent Maxillary Lateral Incisors: A Retrospective Study.

The aims of this study were as follows: 1) to retrospectively evaluate clinical situations of patients with congenitally missing permanent maxillary lateral incisors (CMPMLI) who were referred to three dental clinics specialised in prosthodontics over a 14-year period and 2) to investigate the factors affecting decision-making for patients with CMPMLI. The records of 46 patients with CMPMLI who were treated over a period of 14 years were examined to determine the mechanism of decision-making for treatment planning and factors affecting the decision. Descriptive statistics were used in the initial analysis of the entire data set. In addition, a correlation coefficient-the nonparametric Spearman's rho coefficient-was calculated to trace any possible relation between variables or rank orders. The significance level was set at 0.05 for the analysis. The results of this study revealed that decision-making for treatment of CMPMLI is directly dependent mainly on the following four factors: 1. Patient's age at treatment commencement 2. Individual characteristics of each clinical situation, which play a crucial but not an exclusive role in the treatment approach 3. Synthesis of the participating specialists in the treating team, which plays a crucial role in the decision-making 4. Use of pin-retained resin-bonded bridges (RBBs), either bilaterally attached or cantilevered, proved to be a reliable solution in terms of aesthetics, function and soft tissue response during the study period. Clinical implication: The rationale in the decision-making process for patients with congenitally missing permanent maxillary lateral incisors was investigated in this study to determine whether specific treatment options are superior to others.

Cement failure loads of 4 provisional luting agents used for the cementation of implant-supported fixed partial dentures.

The major disadvantage of cement-retained implant-supported fixed partial dentures (FPDs) is difficulty in retrievability. The retentive strengths of the provisional luting agents usually employed in these cases are therefore an important consideration. This study evaluated the cement failure loads of 4 provisional luting agents used for the cementation of FPDs supported by 2 implants or 4 implants. Nogenol luting agent exhibited the lowest retentive values in both types of FPD. ImProv proved to be the most retentive cement of all tested. Temp Bond NE and Temp Bond presented significantly different values (P < .05) for the 2-implant FPD, but not for the 4-implant model. On the basis of the study results, it may be concluded that Nogenol appears to be more appropriate for cementation of both 2- and 4-implant-supported FPDs when removal of the provisionally cemented superstructure is anticipated.

Fabrication of a custom-made impression tray for making preliminary impressions of edentulous mandibles.

Severe mandibular alveolar ridge resorption is usually observed in patients with long-term edentulism and/or ill-fitting dentures. In some of these patients, the genial tubercles project into the floor of the mouth as a high point in the anterior area of the mandibular residual ridge. The lingual flanges of mandibular stock impression trays usually impinge on the most prominent areas of the resorbed mandibular edentulous ridge (i.e., internal oblique lines and genial tubercles). It is suggested that a preliminary custom tray be made in such cases to pour an initial impression so that individual custom trays can be fabricated. An efficient method for constructing such a custom impression tray from readily available materials is described.

An esthetic and hygienic approach to the use of intracoronal attachments as interlocks in fixed prosthodontics.

This article describes a procedure that uses the Ney MS (Minimal Space) intracoronal attachment as an interlock in a pontic. This procedure overcomes the disadvantages associated with the use of the intracoronal attachments, which are (1) excessive tooth reduction often required to place the attachment within the contour of the crown; (2) compromised embrasures, which result in oral hygiene and periodontal problems; and (3) poor esthetics.

Using cephalometry to evaluate maxillomandibular relationships in complete denture construction.

Long-term denture wearers undergo facial changes as a result of occlusal wear of the dentures and residual ridge resorption. This study examined 12 such patients, presenting with a clinical appearance of Angle's Class III occlusal relationships, to evaluate a clinical method of determining the correct mandibular position. Complete dentures were fabricated for each patient using standard clinical procedures, but acrylic resin blocks were left on the mandibular posterior bases instead of denture teeth. Ensuing changes in maxillomandibular relationships were recorded. After the stabilization of the mandibular relationship, the dentures were completed using mandibular posterior teeth. Patients were evaluated using cephalometric analysis before and after treatment. Results show that a careful procedure of denture fabrication allows the determination of the correct mandibular relationship, even in patients who have experienced extreme facial collapse.